Organization Active NPI

Pharmacy Express Services Inc

  • Community/Retail Pharmacy
  • Council Bluffs, IA
National Provider Identifier
1790799054
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1097 Issued in IA
Legal business name
PHARMACY EXPRESS SERVICES INC
Practice address
1817 W Broadway
Council Bluffs, IA 51501-3823
Phone
(712) 322-5885
NPI assigned
Jul 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bruce S Goldberg
Title
President
Phone
(712) 322-5885

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 1097 IA Primary

Addresses

Primary practice location

1817 W Broadway
Council Bluffs, IA 51501-3823

Mailing address

PO Box 241148
Omaha, NE 68124-5148
Phone (712) 322-5885

Other identifiers 2

IdentifierTypeStateIssuer
0193086MedicaidIA
1620079OtherNCPDP

Other names 1

  • No Frills Pharmacy Express #3 Doing business as

National Provider Directory

National Provider Directory

Locations

1817 W Broadway
Council Bluffs, IA 51501
Phone (712) 322-5885

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1790799054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241148",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681245148",
            "telephone_number": "712-322-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 W BROADWAY",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515013823",
            "telephone_number": "712-322-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACY EXPRESS SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "712-322-5885"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "1097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0193086",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1620079",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "No Frills Pharmacy Express #3",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.